老年高血压病并下肢动脉硬化症的血管内皮功能

目的了解老年高血压病及高血压病合并下肢动脉硬化症(LEASD)患者内皮依赖性舒张功能(FMD)、非内皮依赖性舒张功能(NMD)以及血浆一氧化氮(NO)、内皮素(ET)的水平。方法采用高分辨率超声诊断系统分别检测36例老年高血压病(老年高血压组)患者以及49例老年高血压病合并LEASD(老年高血压合并LEASD组)患者肱动脉的FMD及NMD;同时采用硝酸盐镉还原、比色法测定NO水平(以硝酸盐浓度表示);采用放射免疫法检测ET水平,并分别与40例健康老人(健康老年组)进行对照研究。结果老年高血压合并LEASD组患者肱动脉的FMD及NMD均显著低于老年高血压组和健康老年组(P<0.05),而老年高血压组患者的FMD和NMD亦显著低于健康老年组(P<0.05);老年高血压合并LEASD组患者的NO水平显著低于老年高血压组和健康老年组,而ET却显著高于老年高血压组和健康老年组,而老年高血压组患者NO水平同样显著低于健康老年组,ET水平显著高于健康老年组(P<0.05)。结论老年高血压病及高血压病合并LEASD患者肱动脉FMD及NMD均受损;老年高血压病及高血压病合并LEASD患者均存在血管内皮功能失调,且高血压病合并LEASD患者内皮功能紊乱更严重。

Investigation on the vascular endothelial function of the old hypertensive patients with lower extremity atherosclerotic disease

Objective To evaluate the vascular endothelial function of the old hypertensive patients with lower extremity atherosclerotic disease(LEASD).Methods The endothelium-dependent(FMD)and endothelium-independent dilation(NMD)of brachial artery in 36 old hypertensive patients and 49 old hypertensives with lower extremity atherosclerotic disease were examined by the color Doppler ultrasonograph and compared with those in 40 old healthly controls.At the same time,the plasma levels of nitric oxide(NO) and endothelin(ET) were examined in the above subjects.Results Both FMD and NMD of the brachial artery in the old hypertensive LEASD patients were significantly less than those in old healthy controls and old hypertensive patients(P<0.05).The plasma concentration of NO in the old hypertensive LEASD patients was the lowest,but the ET level was the highest in the hypertensive LEASD patients.Conclusions Both FMD and NMD of the old hypertensive LEASD patients and hypertensives are impaired.Dysfunction of vascular endothelium exists in the old hypertensive LEASD patients and hypertensives.